Azilsartan and Chlorthalidone

Angiotensin-II Antagonist · Angiotensin II antagonist/Diuretic

Indications

It is indicated for the treatment of hypertension, to lower blood pressure. It may be used in patients whose blood pressure is not adequately controlled on mono therapy.

Dosage

Dose is individualized; combination product may be substituted for individual components in patients currently maintained on both agents separately or in patients not adequately controlled with mono therapy (using one of the agents or an agent within the same anti-hypertensive class). May also be used as initial therapy in patients who are likely to need >1 anti-hypertensive to control blood pressure. Adults: Hypertension: Initial therapy: Azilsartan 40 mg/chlorthalidone 12.5 mg once daily; dose may be increases after 2-4 wk of therapy to azilsartan 40 mg/ chlorthalidone 25 mg once daily. Max recommended dose: Azilsartan 40 mg/day; chlorthalidone 25 mg/day. Children: Not recommended.

Adverse Effects

AZILSARTAN: Dizziness, diarrhoea, raised creatine kinase. CHLORTHALIDONE: Electrolyte and metabolic disturbance, gout, rash, postural hypotension, dizziness, GI upset, anorexia, impotence. Rarely photosensitivity, jaundice, arrhythmias, paraesthesia, headache, blood dyscrasias, respiratory disorders, nephritis, pancreatitis.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: AZILSARTAN: Severe hepatic impairment, primary hyperaldosteronism. CHLORTHALIDONE: Anuria, severe renal or hepatic failure, hyponatraemia, hypercalcaemia, hyperuricaemia, sulphonamide activity. Addison’s disease, hypertension during pregnancy. Precautions: AZILSARTAN: Severe renal and mild to moderate hepatic impairment. Intra-vascular volume or salt depletion. CHF, renal artery stenosis, ischaemic cardiomyopathy or cerebrovascular disease. Aortic or mitral valve stenosis, hypertrophic obstructive cardiomyopathy, diabetes, elderly > 75 years. CHLORTHALIDONE: Hepatic and renal impairment, severe renal disease, liver cirrhosis, nephrotic syndrome, diabetes, severe coronary or cerebral arteriosclerosis. Monitor fluid, glucose and electrolytes. Elderly.

Interactions

AZILSARTAN: Potassium sparing diuretics, potassium supplements, heparin, lithium, NSAIDS, ACE inhibitor, aliskiren. CHLORTHALIDONE: Lithium, cardiac glycosides, tubocurarine, ACTH, corticosteroids, ß2 agonists, amphotericin, antidiabetics, NSAIDs, anticholinergics, cholestyramine, colestipol, allopurinol, amantadine, diazoxide, cytotoxics, calcium salts, vitamin D, cyclosporin.

Advice to Patient

Take with or without meals. Complete full course of therapy even if you feel better before completion of course. Contact prescriber immediately if there is any allergic reaction (rash, hives, itching, difficulty in breathing, swelling on face/lips/tongue/throat), dizziness, change in frequency of urination, confusion, drowsiness, loss of appetite, increased thirst, restlessness, unusual weight gain. Certain lab tests are required during treatment, keep all doctors and lab appointments.

Pharmacokinetics

AZILSARTAN MEDOXOMIL: Bioavailability: 60%. Metabolism: Hepatic. Half-life elimination: 11 hrs. Time to peak, plasma: 1.5-3 hrs. Excretion: Faeces (55%). Urine (42%). CHLORTHALIDONE: Onset of action: 2-6 hrs. Duration of action: 24-72 hrs. Bioavailability: 65%. Metabolism: Hepatic. Half-life elimination: Normal renal function: 40-60 hrs. Anuria: 81 hrs. Time to peak, plasma: 1.5-6 hrs. Excretion: Urine (50-65%). Faeces.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.